| Title | Nutritional screening in patients on hemodialysis: is subjective global assessment an appropriate tool? | | Author(s) | Gurreebun F, Hartley GH, Brown AL, Ward MC, Goodship TH | | Institution | School of Clinical Medical Sciences, University of Newcastle upon Tyne. | | Source | J Ren Nutr 2007 Mar; 17(2):114-7. | | Abstract | OBJECTIVE: Malnutrition is common in patients with chronic renal failure and should be screened for systematically. Subjective global assessment (SGA) is frequently used, but it is time-consuming. The aim of this study was to assess the sensitivity of SGA as a screening tool for malnutrition compared with the measurement of body mass index (BMI) and serum albumin combined with a history of unintentional weight loss.
DESIGN: This was a cross-sectional study.
SETTING: The study was undertaken in two hospital hemodialysis units. PATIENTS AND
INTERVENTION: A total of 141 patients on hemodialysis were studied. Nutritional assessment was undertaken with a seven-point SGA, measurement of height, weight and serum albumin, and a record of unintentional weight loss.
OUTCOMES: Patients were considered to be at risk of malnutrition if any of the following three criteria were met: a serum albumin less than 35 g/L, a BMI less than 18.5, and unintentional weight loss of edema free weight greater than 10% in the past 6 months. A diagnosis of malnutrition was made if the SGA score was between 1 and 5.
RESULTS: A total of 41 patients had either a serum albumin less than 35 g/L or a BMI less than 18.5 or unintentional weight loss of edema free weight of more than 10% in the past 6 months. Of these 41 patients, 29 had a serum albumin less than 35 g/L, 9 had a BMI less than 18.5, and 15 had unintentional loss of edema free weight greater than 10% in the past 6 months. Thirteen patients were judged by SGA to be mild to moderately malnourished. All 13 were identified by serum albumin, BMI, or weight loss.
CONCLUSIONS: In this study, measurement of SGA did not diagnose malnutrition in any patients in whom this had not already been potentially identified by measurement of serum albumin, BMI, and a history of weight loss. SGA did not therefore increase the sensitivity of nutritional screening in this cohort. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 17321950 |
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